21D2317295 CLIA NUMBER - MINDBODYPINNACLE HEALTH LLC

Laboratory Demographics

  • CLIA Code: 21D2317295
  • Facility Name: MINDBODYPINNACLE HEALTH LLC
  • Facility Address: 9811 MALLARD DRIVE SUITE 210
    LAUREL, MD
    ZIP 20708
  • Facility Phone: 443 713-8643
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAIWO AJANI
  • NPI Number: 1275263816
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2317295
LAB Type Physician Office
Facility Name MINDBODYPINNACLE HEALTH LLC
Street 9811 MALLARD DRIVE SUITE 210
City LAUREL
State MD
ZIP 20708
Phone 443 713-8643
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Physician Office
Lab Director TAIWO AJANI

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This page was last updated on: 9/29/2025